A nurse is assessing a pregnant client diagnosed with HELLP syndrome. Which of the following findings is most concerning?

Blood pressure of 140/90 mmHg

Platelets 250,000/mm3

Right upper quadrant pain

Fetus expected weight for gestation

Answer and Explanation

The Correct Answer is C

A. Blood pressure of 140/90 mmHg: While elevated, this blood pressure reading is at the threshold of hypertension and is common in HELLP syndrome. It is not the most alarming finding unless it continues to rise or is accompanied by signs of end-organ damage.

B. Platelets 250,000/mm³: This is within the normal range and does not reflect thrombocytopenia, which is a hallmark of HELLP syndrome. A concerning platelet count would be below 100,000/mm³, suggesting a risk for bleeding complications.

C. Right upper quadrant pain: This symptom may indicate liver involvement, such as hepatic swelling or rupture, and is a serious sign in HELLP syndrome. It can signal worsening disease and the need for immediate evaluation and possible intervention.

D. Fetus expected weight for gestation: A fetus growing appropriately is a reassuring sign in pregnancy. HELLP syndrome can lead to fetal growth restriction, but expected weight indicates adequate placental function at the moment and is not an urgent concern.

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Correct Answer is C

Explanation

A. Development of scoliosis in the spine: Scoliosis is a lateral curvature of the spine and is not a typical change during pregnancy. Pregnancy usually leads to lumbar lordosis, not scoliosis. This spinal shift affects posture but is not responsible for a waddling gait in pregnancy.

B. Increased blood volume leading to leg swelling: While increased blood volume can cause leg swelling and discomfort, it does not significantly alter the mechanics of walking. Edema may cause heaviness but not the joint instability seen with a waddling gait.

C. Relaxation of pelvic ligaments and joints: Pregnancy hormones like relaxin cause pelvic ligaments and joints to loosen in preparation for childbirth. This increased mobility alters pelvic alignment and stability, leading to the characteristic waddling gait.

D. Increased muscle strength in the lower extremities: Muscle strength typically does not increase during pregnancy; fatigue and reduced endurance are more common. Stronger muscles would improve balance, not cause a waddling gait, making this an unlikely factor.

A. "There is no way to predict how long it will last in each individual client." B. "In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone." C. "It occurs during the first trimester and near the end of the pregnancy." D. "It's a minor inconvenience, which you should ignore."

Correct Answer is C

Explanation

A. "There is no way to predict how long it will last in each individual client.": Although experiences can vary, there are well-established physiological patterns for urinary frequency in pregnancy. This response is vague and does not offer the client helpful information about what to expect.

B. "In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone.": Urinary frequency typically improves after the first trimester but returns near term due to increased uterine pressure. This response incorrectly links its persistence to bladder tone rather than uterine changes later in pregnancy.

C. "It occurs during the first trimester and near the end of the pregnancy.": Urinary frequency is common in early pregnancy due to hormonal effects and increased blood flow to the pelvis. It usually subsides in the second trimester but returns in the third trimester as the enlarging uterus presses on the bladder again.

D. "It's a minor inconvenience, which you should ignore.": Dismissing the symptom as a minor inconvenience overlooks the importance of client education. Clients should be encouraged to report concerning symptoms and receive supportive, informative responses from healthcare providers.

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A nurse is assessing a pregnant client diagnosed with HELLP syndrome. Which of the following findings is most concerning?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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